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Richard Bernstein, MD

Pulmonary Medicine | Allergy & Immunology

Proudly Part of Privia Health

The Role of Respiratory vaccines as part of your healthcare strategy

The Role of Respiratory vaccines as part of your healthcare strategy. FAQ’s

Our role as healthcare providers is to educate our patients regarding their health care. As a pulmonologist I am a strong advocate for vaccination as a cornerstone of treatment to help prevent respiratory illness. It is always easier to prevent disease, then to treat it. We as a practice, also recognize that the decision to receive vaccination is personal and we respect that decision.

Simply put, vaccines have saved more lives than any medical intervention in history. COVID aside, the best examples of this include smallpox, polio, meningitis, measles, mumps and rubella. These diseases carried high mortality rates and have basically been eradicated due to vaccines.

FLU;

The flu shot reduces the likelihood of serious symptoms from the flu by about 50 to 60% but does not mean you cannot get the flu. In children, 80% of children who died from the flu did not get the flu vaccine. The number of deaths each year from the flu varies.  In 2011/12 about 12,000 people died from the flu, but in 2017/18 it is estimated 52,000 people died

The flu also is associated with comorbidities.  The risk of having a heart attack in patients with underlying heart disease is increased by 600% within the first week of the flu.  There is also a significant increased risk of having a stroke.  This risk is significantly reduced by getting a flu vaccine.

No

COVID:

In the U.S. it is estimated 3.2 million lives were saved, globally estimates range from 14-19 million. It is estimated hospitalizations in the U.S. were reduced by 18 million.

Yes. Hospitalization rates are relatively high 13,000 (Oct 19, 2023). 240,000 people died from Covid in 2022. 62% of these patients were over age 65. The main benefit for most of us however is preventing complications from COVID illness. Complications can include stroke, myocardial infarction, atrial fibrillation, pneumonia, and long COVID. The vaccine helps prevent complications, long COVID symptoms, and severity of long COVID symptoms.

A minimum of 2 months

No! It generally takes about 10 years to achieve herd immunity from a novel virus like Covid. Vaccines have certainly accelerated this process. During the polio epidemic 80% of the population had to be immunized to achieve herd immunity. However, because of the multiple mutations that occur with COVID at such a rapid pace it is unclear if we will ever achieve true herd immunity.

No

RSV;

RSV is a respiratory virus that tends to affect children up to age 5 as well as adults over age 65. Particularly vulnerable are infants up to 1 year, children with underlying lung disease, and adults who have underlying respiratory disease, cardiac conditions, or weakened immune systems. Nursing home patients are particularly vulnerable. It tends to cause pneumonia, bronchitis, and asthma-like symptoms with mucous plugging and wheezing. RSV is a leading cause of hospitalization in infants.

Adults over age 60 are eligible, but particularly those at risk should be immunized. The best way to immunize infants is for pregnant women to be immunized between weeks 32 and 36 of pregnancy. In the future, those who are exposed to infants may be recommended to have the vaccine much as we do today with pertussis but this is not a current recommendation.

Currently there are 3 options. The GSK vaccine is a more traditional vaccine. Pfizer and Moderna have both received FDA approval for their messenger RNA versions of the vaccine as well. They currently are not as available.

At this time this is unknown. These clinical trials are ongoing.

Pneumococcal Vaccine

This vaccine protects against the most common form of bacterial infections of the respiratory tract which can include the lungs, sinuses, and inner ear.  Over the years there have been different variants of this vaccine.  The first was the Prevnar 13, then the Prevnar 15, and now the Prevnar 20 vaccine.  Initially it was recommended you get a Prevnar 13 and then a year later the old pneumococcal vaccine which was the PPSV23 vaccine.  Current recommendations are for only the Prevnar 20 vaccine.  It is indicated for people over age 65, or people with chronic respiratory conditions or immunosuppression that predispose them to pneumonia or chronic sinus infections.  There is no downside to getting a newer version of the vaccine if you have had a previous version.

Richard Bernstein M.D. F.C.C.P.

Pulmonary Medicine

Medical Director Privia Clinical Research Mid-Atlantic 10/30/2023 RAB

*The main contraindication to vaccination, is a history of anaphylaxis or severe allergic reaction to vaccines or its components.  If you have a history of this please discuss with your physician prior to receiving vaccination.